High fibular fracture above the syndesmosis resulting from external rotation

Often, there is injury to the medial ankle either a tranverse medial malleolar fracture, posterior malleolar fracture or disruption of the deltoid ligament

Disruption of the syndesmosis and interosseous ligament up to the fibular fracture site

Suspicious for this fracture if you see a 1) transverse medial malleolar fracture or 2) posterior malleolar fracture but no fibular fracture on the ankle radiographic series. In these situation, a full-length fibular radiograph should be taken

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